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In vitro tools to monitor drug susceptibility and dynamics of drug resistance in field isolates of Leishmania donovani and L. infantum
No full textIntraventricular Taenia solium neurocysticercosis: a report of three cases
No full textNeurocysticercosis (NCC), caused by the pork tapeworm Taenia solium, is reported to be a common condition in Nepal. So far imaging diagnosis was mainstay of the diagnosis. In this paper, we report three patients presenting with neurological symptoms due to intraventricular NCC. We have diagnosed the causative agent as T. solium on molecular basis. Further research is warranted to assess the actual health impact of T. solium in Nepal
The Rockefeller Foundation's "Public stewardship of private providers in mixed health systems": a point-by-point critique
No full textChallenges of HIV care in low-income countries; experience from a pilot project in Cambodia 2003-2007
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A head-to-head comparison of four artemisinin-based combinations for treating uncomplicated malaria in African children: a randomized trial
No full textBACKGROUND: Artemisinin-based combination therapies (ACTs) are the mainstay for the management of uncomplicated malaria cases. However, up-to-date data able to assist sub-Saharan African countries formulating appropriate antimalarial drug policies are scarce. METHODS AND FINDINGS: Between 9 July 2007 and 19 June 2009, a randomized, non-inferiority (10% difference threshold in efficacy at day 28) clinical trial was carried out at 12 sites in seven sub-Saharan African countries. Each site compared three of four ACTs, namely amodiaquine-artesunate (ASAQ), dihydroartemisinin-piperaquine (DHAPQ), artemether-lumefantrine (AL), or chlorproguanil-dapsone-artesunate (CD+A). Overall, 4,116 children 6-59 mo old with uncomplicated Plasmodium falciparum malaria were treated (1,226 with AL, 1,002 with ASAQ, 413 with CD+A, and 1,475 with DHAPQ), actively followed up until day 28, and then passively followed up for the next 6 mo. At day 28, for the PCR-adjusted efficacy, non-inferiority was established for three pair-wise comparisons: DHAPQ (97.3%) versus AL (95.5%) (odds ratio [OR]: 0.59, 95% CI: 0.37-0.94); DHAPQ (97.6%) versus ASAQ (96.8%) (OR: 0.74, 95% CI: 0.41-1.34), and ASAQ (97.1%) versus AL (94.4%) (OR: 0.50, 95% CI: 0.28-0.92). For the PCR-unadjusted efficacy, AL was significantly less efficacious than DHAPQ (72.7% versus 89.5%) (OR: 0.27, 95% CI: 0.21-0.34) and ASAQ (66.2% versus 80.4%) (OR: 0.40, 95% CI: 0.30-0.53), while DHAPQ (92.2%) had higher efficacy than ASAQ (80.8%) but non-inferiority could not be excluded (OR: 0.35, 95% CI: 0.26-0.48). CD+A was significantly less efficacious than the other three treatments. Day 63 results were similar to those observed at day 28. CONCLUSIONS: This large head-to-head comparison of most currently available ACTs in sub-Saharan Africa showed that AL, ASAQ, and DHAPQ had excellent efficacy, up to day 63 post-treatment. The risk of recurrent infections was significantly lower for DHAPQ, followed by ASAQ and then AL, supporting the recent recommendation of considering DHAPQ as a valid option for the treatment of uncomplicated P. falciparum malaria. TRIAL REGISTRATION: ClinicalTrials.gov NCT00393679; Pan African Clinical Trials Registry PACTR2009010000911750 Please see later in the article for the Editors' Summary
Factores que dificultan la coordinación entre niveles asistenciales: un estudio de caso en Colombia
No full textThe production of critical theories in health systems research and education: an epistemiological approach to emancipating public research and education from private interests
No full textWill visceral leishmaniasis be eliminated from Nepal? A review of recent (1994-2006) control efforts
No full textKonzo and dietary pattern in cassava-consuming populations of Popokabaka, Democratic Republic of Congo
No full textFood frequencies and 24h diet recall were registered from 487 randomly selected heads of household in Popokabaka (Bandundu Province, DRC) where the first cases of konzo were reported more than seventy years ago. Konzo is still occurring in this area with a prevalence of 1.4%.. High prevalence of konzo was found to be associated with female gender (P = 0.0024), unmarried status (P = 0.030), illiteracy (P = 0.021), farmer as main occupation (P< 0.05) and with consumption of cassava from own farm land (P = 0.045). The diet was largely dominated by cassava. Luku, cassava flour stiff porridge, was consumed at least once during the day in 99.2% of households. A median of 304 g (max 592 g; min 120 g) of cassava flour providing 1070 Kcal (max 2085 Kcal; Min 422 Kcal)/ day/person was used to prepare luku. Saka-saka (pounded cassava leaves) (40%), cowpeas (30%), sesame (23.2%), mbondi (Salacia pynaertii) (18.1%), mushrooms (17.7%) and mfumbwa (Gnetum Africanum) (11.3%) were consumed as side-dishes with luku. These results showed that major foods consumed are of poor quality in protein, especially in sulphur containing amino acids